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Sodium Azide Poisoning

TOXIC SYNDROME DESCRIPTION

The purpose of this document is to help health care workers and public health officials to recognize an unknown or suspected exposure to sodium azide. Sodium azide is a rapidly acting, potentially lethal chemical that exists as an odorless, white crystalline solid. It is used in automobile airbags to produce inflation of the airbag upon impact; after deployment, sodium azide is converted to nitrogen gas. Sodium azide is converted rapidly into hydrazoic acid vapor upon contact with water or an acid. Like sodium azide, hydrozoic acid is highly explosive. Similar to cyanide, sodium azide and hydrozoic acid also interfere with cellular respiration and aerobic metabolism, preventing the cells from using oxygen. The central nervous system and the cardiovascular system are most sensitive to acute sodium azide poisoning.

The amount and route of the exposure to sodium azide and the premorbid condition of the exposed person will contribute to the time of onset, duration, and the severity of illness.

Signs and symptoms of exposure

Following is a list of signs and symptoms that may be encountered in a person exposed to sodium azide. Signs and symptoms are not listed in order of importance, presentation or specificity. Also, partial presentations (an absence of some of the following signs/symptoms) do not necessarily imply less severe disease.

Central nervous system signs and symptoms

Agitation

Coma

Convulsions

Dizziness

Headache

Loss of consciousness (sudden collapse)

Respiratory signs and symptoms

Bradypnea (decreased respiratory rate)

Chest pain

Dyspnea (shortness of breath)

Hyperpnea (increased respiratory rate/depth)

Cardiovascular signs and symptoms

Bradycardia (decreased heart rate)— late

Flushing

Hypertension (high blood pressure)— early

Hypotension (low blood pressure)— late

Tachycardia (increased heart rate)— early

Gastrointestinal signs and symptoms

Abdominal pain

Nausea

Vomiting

Other signs

Similar color of retinal arteries and veins

Skin and eye irritation

Laboratory findings suggestive of sodium azide poisoning

Metabolic acidosis

Elevated anion gap

Increased plasma lactate concentration

Differential diagnosis – poisoning with

Carbon monoxide

Cyanide

Ethylene glycol

Fluoroacetate

Hydrogen sulfide

Methanol

Phosphine

Note: The actual clinical manifestations of an exposure to sodium azide may be more variable than the syndrome described in this document.